婴儿晚发性维生素K缺乏致颅内出血的CT诊断

CT diagnosis of intracranial hemorrhage due to delayed vitamin K deficiency

目的:分析晚发性维生素K缺乏致颅内出血的CT表现、疗效观察及预后判断。方法:对7年间所诊断的33例婴儿晚发性维生素K缺乏致颅内出血的临床资料及CT资料进行回顾性分析。结果:CT显示蛛网膜下腔出血最多见(26例),其次为硬膜下出血(21例)、脑内出血(16例),脑室内出血少见(5例);多部位混合出血多见,有两个以上出血部位者23例,占69.7%,可出现大片脑梗塞及脑缺氧缺血性病变、脑水肿。硬膜下血肿及蛛网膜下腔出血吸收较完全;脑内血肿范围较大,特别是伴有大片脑梗塞者可有脑软化灶和后遗症。结论:婴儿晚发性维生素K缺乏致颅内出血的CT表现有一定的特征性,CT能起到定位定性的作用,并且对临床的疗效观察和预后判断等方面亦起重要作用。

Objective To analyse the CT findings,therapeutic evaluation and p ro gnostic estimation for intracranail hemorrhage due to delayed vitamin K deficien cy. Methods The clinical data and CT features of 33 cases encountered in the pas t 7 years were retrospectively analyzed. Results Subarachnoid hemorrhage (SAH:2 6 cases) was most commonly seen,followed,in turn,by subdural hemorrhage (SDH :21 cases),intracerebral hemorrhage (ICH:16 cases) and,rarely,intraventricu lar hemorrhage (IVH:5 cases). The intracranial hemorrhage showed multi-locatio ns with mixed features. Hemorrhage over two sites was found in 23 cases (69.7%) . Possibly accompanying large area cerebral infarction and hypoxic ischemic lesi ons. The subdural and subarachnoid hematoma could be completely absorbed. Large intracerebral hematoma,especially with infarction,could lead encephalomalacia and result sequelate to the patient. Conclusion The CT appearance of intracrania l hemorrhage due to delayed vitamine K deficiency had specificities. CT play an important role in localization and qualitative acknowlegement,and,thus,plus, in evaluation of clinical treatment and in estimation of prognosis.